sexual disorders

Question 1

What is Gender Dysphoria?

Answer 1

Gender Dysphoria is characterized by a strong and persistent identification with the opposite gender and discomfort with one’s own gender.

Previously known as ‘Gender Identity Disorder’.

Question 2

How does homosexuality differ from Gender Dysphoria?

Answer 2

Homosexuals maintain and are comfortable with their gender identity, unlike individuals with Gender Dysphoria.

Question 3

What are some historical features of Gender Dysphoria?

Answer 3

Historically very rare (less than .01%), but prevalence has increased significantly in recent years.

Question 4

What happens to children with Gender Dysphoria as they grow?

Answer 4

Most children with Gender Dysphoria do not have this condition persisting into adolescence. If it does persist, it is usually permanent.

Question 5

What is the commonality of Gender Dysphoria among transgender adults?

Answer 5

Almost all transgender adults had Gender Dysphoria when younger.

Question 6

What is the historical gender ratio for Gender Dysphoria?

Answer 6

Historically, it was 2-5 times more common for biological boys/men to have a female gender identity than the reverse, but this ratio has now reversed.

Question 7

What are common behaviors observed in children with Gender Dysphoria?

Answer 7

Girls may be very tomboyish and boys may be effeminate. Dressing as the opposite gender is common.

Question 8

What are the sexual preferences of individuals with Gender Dysphoria?

Answer 8

Females wanting to be males usually erotically prefer females; however, only 50% of males wanting to be females are attracted to males.

Question 9

What mental health issues are common in individuals with Gender Dysphoria?

Answer 9

Anxiety and depression are very common.

Question 10

What cultural recognition exists for additional genders?

Answer 10

Three genders are normative in several cultures, including Two-Spirit in North American Indigenous societies and Fa’afafine in Samoa.

Question 11

What are the genetic causes of Gender Dysphoria?

Answer 11

Twin studies show significant heritability, and sex chromosome abnormalities are sometimes present.

Question 12

What neurobiological evidence supports Gender Dysphoria?

Answer 12

Some evidence suggests differences in prenatal androgen exposure and that the brains of boys with Gender Dysphoria resemble those of females, especially in areas associated with sexual orientation.

Question 13

How can parenting behavior influence Gender Dysphoria?

Answer 13

While genetic and neurobiological causes are likely primary, parenting behavior can influence gender expression but not gender identity.

Question 14

What is Hormone Therapy (HT) in the context of Gender Dysphoria?

Answer 14

Adults with Gender Dysphoria usually have improved mental health when taking sex hormones consistent with their gender identity.

Question 15

What is the treatment approach for adolescents with Gender Dysphoria?

Answer 15

Adolescents who have had Gender Dysphoria since childhood tend to have improved mental health with puberty blockers.

Question 16

Why is Hormone Therapy inadvisable for children with Gender Dysphoria?

Answer 16

Hormone Therapy is inadvisable for children due to the very high remission rate.

Question 17

What is the controversy surrounding Hormone Therapy in adolescents?

Answer 17

It is controversial in adolescents without prior Gender Dysphoria due to the recent increase in prevalence and high remission rates in children.

Question 18

What is Sexual Reassignment Surgery?

Answer 18

Usually restricted to adults (18+) and done in conjunction with hormonal therapy.

Question 19

What are the satisfaction rates for Sexual Reassignment Surgery?

Answer 19

> 75% of individuals are satisfied with the outcome and show evidence of improved psychosocial adjustment; however, they continue to have high risks of suicide and psychiatric comorbidity.

Question 20

What is the effectiveness of behavioral techniques in treating Gender Dysphoria?

Answer 20

Very little evidence suggests that behavioral techniques or other types of ‘conversion therapy’ can modify gender identity.

Question 21

What are Paraphilias?

Answer 21

Paraphilias involve unusual imagery or acts necessary for sexual excitement.

Question 22

What are some types of Paraphilias?

Answer 22

Types include fetishes, transvestism, zoophilia, exhibitionism, voyeurism, masochism, sadism, frotteurism, and pedophilia.

Question 23

What are common features of individuals with Paraphilias?

Answer 23

Typically males, typically chronic, and most have more than one paraphilia.

Question 24

What is the prevalence of Paraphilias?

Answer 24

The prevalence is unknown but they are not uncommon.

Question 25

What are the genetic and evolutionary causes of Paraphilias?

Answer 25

Females are genetically primed to be more discriminating about sexual interests, while males are evolutionarily less discriminating and more susceptible to developing unusual sexual associations.

Question 26

How does associative learning contribute to Paraphilias?

Answer 26

It takes associative learning for a paraphilia to develop, where sexual arousal in the presence of a paraphilic object reinforces the association.

Question 27

What are the treatment options for Paraphilias?

Answer 27

Treatment is difficult; ‘orgasmic reorientation’ may be used, and antiandrogens can reduce sex drive but not the association.

Question 28

What is the effectiveness of psychotherapy for Paraphilias?

Answer 28

Psychotherapy is not effective.

Question 29

What is the potential role of SSRIs in treating Paraphilias?

Answer 29

Some evidence suggests that SSRIs may be helpful, possibly due to their sexual dysfunction side effects.